Provider Demographics
NPI:1003977448
Name:PARKER, WILLIAM A (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:A
Last Name:PARKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15875 SE 114TH AVE STE C
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-9025
Mailing Address - Country:US
Mailing Address - Phone:503-839-2000
Mailing Address - Fax:503-305-8027
Practice Address - Street 1:15875 SE 114TH AVE STE C
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015
Practice Address - Country:US
Practice Address - Phone:503-839-2000
Practice Address - Fax:503-305-8027
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3589111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor